Rules and regulations

Dental offices must comply with a bevy of federal, state, and even local regulations. Although too many exist to list in one article, practitioners must nevertheless stay abreast of these rules. One way to remain current is by participating in health and safety compliance programs offered locally.

Charles John Palenik, MS, PhD

Dental offices must comply with a bevy of federal, state, and even local regulations. Although too many exist to list in one article, practitioners must nevertheless stay abreast of these rules. One way to remain current is by participating in health and safety compliance programs offered locally. Another is to work with an association that concentrates on these topics such as the Organization for Safety and Asepsis Procedures (www.osap.org.)

The Occupational Safety and Health Administration (OSHA) is the prime federal agency involved with workplace health and safety. OSHA's mission is to prevent work-related injuries, illnesses, and deaths. Twenty six states also run their own OSHA programs.

OSHA enforces its standards through workplace inspections, and, when necessary, through the imposition of citations and monetary penalties. OSHA also provides technical and compliance assistance, training, and education directly to employers and employees. It conducts health and safety research, develops innovative ways of dealing with workplace hazards, and maintains records of workplace injuries and illnesses.

Valuable information on standards and regulations as well as necessary forms are available on the OSHA Web site (www.osha.gov). Of special interest to dentists are model plans and advice concerning required office policy documents. For example:

•OSHA Bloodborne Pathogens Standard (29 CFR Part 1910.1030) - Written exposure control plan and post-exposure and follow-up requirements. www.osha.gov; look for "Bloodborne Pathogens" on the menu.

•OSHA Occupational Exposure to Hazardous Chemicals in Laboratories (29 CFR Part 1450) - Written chemical hygiene plan. Go to the letter "H" on the site's alphebetical index; look for "Hazard Communications."

•OSHA Employee Emergency and Fire Prevention Plans (29 CFR 1910.38) - Employee emergency and fire prevention plans (www.osha-slc.gov/OshStd_data/1910_0038.html).

The Centers for Disease Control and Prevention (CDC) also is involved with health and safety issues in dentistry. Advice to health care workers usually comes in the form of recommendations, not as regulations. However, CDC recommendations are often quoted during litigation and are used by other agencies (including OSHA) in the generation of its standards and by professional organizations and state dental boards. The CDC maintains a valuable Web site (www.cdc.gov) which provides current information, training, and sets of recommendations.

In 1993, the CDC issued its most current recommendations concerning infection control in dentistry (www.cdc.gov/mmwr/pre view/mmwrhtml/00021095.htm). An update is expected in early 2003. The CDC has prepared positions and recommendations on seven topics specific to infection control in dentistry (www.cdc.gov/Oralhealth/fact sheets/index.htm), including blood and waterborne disease transmission, safer use of toothbrushes, biofilms and dental unit water, backflow prevention, procedures to be used during a boil water alert, and the potential spread of TB.

Effective compliance with these regulations requires dental offices to first identify which tenets apply to their situations and then develop a coordinated response. In order to establish and maintain such a program, personnel in the office must secure the necessary information and compliance materials first, and then develop an overall compliance response.

Staying current requires additional research, reading, and, most likely, attendance at health and safety compliance programs.

Dr. Charles John Palenik is an assistant director of Infection Control Research and Services at the Indiana University School of Dentistry. Dr. Palenik has authored numerous articles, book chapters and monographs, and is the co-author of the popular Infection Control and Management of Hazardous Materials for the Dental Team. He serves on the Executive Board of OSAP, dentistry's resource for infection control and safety. Questions about this article or any infection control issue may be directed to office@osap.org.

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